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Coding Tip- Always Follow Client Guidelines

Ok, well this might be a no-brainer, but always follow client guidelines. I know you already have to think about all of the ‘real’ coding guidelines, but that does not mean that clients don’t have their own that you must follow too. This makes your job as a coder a little more difficult because there’s more to remember, but eventually you’ll be able to code and your clients guidelines will become second-nature.

So, what am I talking about exactly? Most clients that I’ve coded for have their own set of rules. I’m not saying that these contradict real coding guidelines, but basically clients have rules too. For example, there may be guidelines on whether or not to use the LT/RT modifiers or modifier 50. There may be client guidelines on what to do if the report has documentation issues, or if some info is completely missing. You should know if your client wants outside reads coded because some do, some don’t. A very important one you should know is whether or not your client needs you to add modifier 26 or not. You will get this info before you start actually working for the client. They should send you a pdf or another document specifying their guidelines.

There could be many different client guidelines and the ones I mentioned are just a few that are possible. Always remember to check your client coding guidelines if you come across a situation that you’re unfamiliar with and you will hopefully find the answers to your questions. If not, then the best thing to do would be to contact your lead coder/coding manager for clarification.

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Tabs For The ICD-10-CM Book

I was thinking about “coding hacks” that make my life easier. For my job as well as many others out there, coding speed is an important factor. We have to code a certain amount of charts in a certain amount of time. This can be tough to do especially if you rely solely on your books. But it’s a catch 22 because I WANT to rely on my books.

I’ve done way too many audits where the codes were chosen buy an engine. These codes were incorrect for a variety of reasons–laterality, order of codes, or just completely wrong for no apparent reason. All of this has led me to use my coding books when I do my coding.

So I made these tabs and it is a lifesaver. I can code faster because I can find the codes quicker. Also, what I like best about the tabs is that they are double-sided so I can see all parts of the book without flipping back to the beginning. This is good for coders already working, but I think this might be especially beneficial to people taking their coding exams.

So I decided to make more of these and make them available to other coders who can benefit.

There are 60 pre-printed, multi-colored, double-sided tabs included,

for $14.99.

Please see the pics below!

To purchase, please scroll to the bottom of the page.

Tabs For The ICD-10-CM Book

This product contains 60 pre-printed, double-sided tabs for the ICD-10-CM book.

$14.99

This item is in production and will ship on August 28, 2018.

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Is Diagnostic Radiology Coding Really Easy?

Ok, I’ll just come out and say it–many times in coding discussions, I’ve heard people say that diagnostic radiology coding is easy. That it’s a good place for new coders to start. I’m not really sure how I feel about that. Not that it’s not a good place for new coders to start (it is) but that it’s so easy– anyone can do it. I’ll admit it’s much easier that interventional radiology coding, and some of the other specialties out there…but diagnostic radiology is it’s own specialty. It has it’s own set of rules and if you’re not a radiology coder–you won’t be familiar with it. I mean, yes, you could learn it–that’s why I started this website–to help new coders learn–but does it sound weird if I feel bad that people think it’s very easy to code?

For starters, here are some of the little idiosyncrasies that a diagnostic radiology coder knows off the top of her/his head:

*Understands modifier 26 and TC

*When to use modifiers 59/76/77/52/53

*How many organs are in a complete abdominal ultrasound vs limited

*The difference between all of the different types of OB ultrasounds

*The documentation requirements for spectral Doppler (now if we can teach radiologists how to document this right, we’ll really be in good shape).

*The different contrast codes for mri’s and ct scans

*Understand the difference between an mri, mra, ct, cta and pet scan

*Difference between a screening and diagnostic mammogram

*The physician ordering rule

*All the different cpt codes for x-rays

*The different types of x-ray views

*Knows the codes in the 7000 series without looking in the cpt book

*All of the different PQRS codes that may be required and the documentation requirements for each

*Understands that “initial encounter” for fractures/injuries does not mean first encounter.

*The whole ICD-10-CM book because codes are used from every section!

 

Another part of diagnostic radiology coding that is specific to it, is the speed at which you’re expected to code. On average, a coder should do 60 reports an hour at 97% accuracy. Many coders can do more, but this is the expected rate. There are short cuts–like different encoders that can help coders keep up the pace, but ideally I think a radiology should be able to code 60 an hour without much help. It’s a specialty where there always is a lot to code, so you have to hit the ground running.

The only way to work your way up to that speed is by practicing! There are no short cuts. I once had a teacher that said “the more you practice, the better you get.” That still holds true years and years later (Thank you Mrs. Jaffe). Here is a free diagnostic radiology coding test if you’re looking for more practice.

Anyway, with all that being said–I love diagnostic radiology coding and I know I’m biased, but I just think it’s the best and I can’t help but feel bad if people put the specialty down without fully understanding it.

All of the above topics (and more) are things I plan to talk/write about at some point, so if you’re interested in learning–keep following this blog and facebook page 🙂

 

 

 

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Recommendation- Read This Book To Learn How To Do Well On Interviews

Interviews are nerve-wracking

Everyone knows it can be really tough to get that first medical coding job. People will give you all kinds of tips–such as “get a foot in the door job” or “apply to everything!” While there definitely is some value in that advice, something that I think that is often overlooked is the interview process itself. You know you’ll get asked the basic questions and most likely have answers ready for those, but that’s not what this article is really about. You can have the best answer to an interview question ever, but if you don’t sound confident when you say it, it doesn’t really matter what you’re saying. The interviewer will get the vibe that you’re just not confident, and that just is not the image you want to project.

See, I have no problem saying those things, because I was that person. I used to come across very shy/not confident in interviews. That wasn’t my goal obviously so it was something I had to work on. While you’re applying for jobs, a thing you can do to prepare yourself for that interview, is to read books about how to interview well. At first that might not seem like a thing to actually do, but let me tell you, it is helpful.

Read books to learn how to come across better on interviews.

When I was looking for a job way back when, I remember it was around the holidays. I went up to the attic to put away some decorations, and there was a book laying on the floor, from 1998. It was titled “The Perfect Interview.” I guess I had that book laying around since my college days but I didn’t remember actually reading it. So here I was about 15 years later and this book still seemed relevant to me. I dusted it off, and read it in a few days. It was filled with tips on little things you can do just to come across more confident even if you’re not. After reading this book, I went on an interview and was offered my first coding job. I’m not saying this book will 100% guarantee you get offered a coding job if you read it, but it definitely is worth it if you’re trying to brush up on your interview skills.

I tried to find the link to the exact book I read but since it is very old, I don’t think it’s available anymore. Notice I said the book is old. I am not old 🙂

I’m attaching a link to a book that is the next edition to the one I read.

Here it is!

 

I hope this helps you! Good luck on your job interviews!

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The Reality Of Being A Medical Coder Who Works From Home

Not a picture of my desk. It would be nice if it looked this neat though.

Many times, if you’re looking at advertisements for coding schools, you’ll see a picture of a young woman working at a laptop. She looks happy and she may be even holding  a baby on her lap. I’ve also seen other advertisements where there’s a picture of someone coding at the beach. I’m not trying to burst anyone’s bubble here, but that is not an accurate depiction of life as a medical coder working from home. I’ll get back to what it’s actually like later on in this post-but some medical coders do work from home and are very successful at it.

What people don’t realize is there’s a lot more than meets the eye. I think some of the schools out there totally underestimate the importance of working on-site first. So much can be learned from that! Not only will you get to meet other coders in your specialty, but you’ll get to see how the whole process works. There’s a lot more to coding than choosing numbers in a book, and the only place to learn these things is on-site. If you work in a billing office you’ll get to see the whole claim cycle, which is important just to grasp things, and see how coding fits into the whole equation. You may even find a coder to mentor you and show you the ropes, which is invaluable! Networking and building relationships with other people is necessary in this field. So while working from home can be a perk of working in this field down the line, it should not be your goal starting out.

Actual picture of my desk. This is Connor and he is my pet supervisor.

So what is it like working from home? The first thing to keep in mind that there are still rules. You still have to have a HIPAA compliant space to work and need to follow your companies guidelines regarding that. Some companies are more strict than others. Some require you have a separate office with a door that locks, others do not. Some companies provide a computer and others require you use your own. Some companies have set hours you have to work while others do not. You get the idea–it’s not as flexible as it may seem at first.

Believe it or not, it can be tough to keep a schedule when you work from home. If you’re allowed to set your own hours, it is very easy to lose track of time. You may start cleaning or cooking or whatever and next thing you know the day is half over. There are many distractions in the home and it’s easy to get side tracked. The best thing to do to avoid this, is to make a schedule and stick to it.

Friend- “Since you’re home all day, you sleep until noon, right?” Me- “That’s not how it works.”

Another problem that many coders have that work from home is the fact that many people think that since you’re working from home, you do not have a real job. They do not respect your work boundaries and think you are around to help with errands, chores etc. But the fact of the matter is, it is up to YOU to set boundaries with people in your life. If your family and friends think that you’re available to help them with things because you’re home, don’t be afraid to tell them no. Would these same people call you if you were at the office for help with an errand? Probably not.

It’s tough when you’re a new coder. You can do well but it just takes time.

I also think that working from home should be for experienced coders only. If you are a new coder and have a question–there is no one around to ask. Production and accuracy are still expected whether you work in the office or at home, and when you’re first learning, it’s to your advantage to be around others to help you if needed.

Another thing to consider before working from home is your personality. This might sound weird but just think about it for a second. If you’re a person who likes to work alone and is ok with being home most of the day, then working from home can work out for you. But if your are a people-person who truly enjoys being around others–you may not like working from home. It can be very isolating and that fact alone can be upsetting to a very social person.

Not a medical coder.

Last but not least–getting back to that picture I mentioned earlier of someone coding at the beach. Many times when you start working a new job you’ll have to sign a contract or an agreement. Usually there is a clause in there saying that you have to actually work in your house and not somewhere in public. It is a HIPAA issue if someone can see your work/computer screen. You also most likely need a secure internet connection to work and it also may need to be a wired connection. Not to mention, all of the seagulls would be very distracting if you’re trying to work on the beach. All kidding aside, as a mom myself I get that it’s appealing to want to work from home. It’s just that the reality of how it really is, is not depicted accurately by some coding institutions out there, and sets students up with unrealistic expectations about the coding world.
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Why It’s Beneficial To Know How To Code Diagnostic Radiology

I just wanted to shed some light on something. I’m not sure if this is the best topic for one of my first blog posts, but here it is anyway. The other day, the topic of off-shoring came up in a coding discussion. It is a sensitive subject and we can’t pull the wool over our eyes and pretend it’s not there. But I don’t want new coders to feel that they should avoid learning diagnostic radiology coding, thinking it would be a waste of time and abandon ship. The fact is that coding in ALL specialties can end up going off-shore. This is something that happens in any coding specialty and is not diagnostic radiology coding-specific. Say what you will, but this is something that most coders are well aware of, and I have never heard of that fact alone being the sole reason that someone does not pursue radiology coding.

Another thing to keep in mind too, is that coding needs to be audited. Not just radiology coding but all coding, no matter where it is coded originally. Usually the coding gets audited here in the USA. Now, I’m sure there are exceptions to this somewhere out there, but in my experience this has been the case. In order to audit it, you have to know how to code it first right? So if it is something you’re interested in, don’t miss the boat!

Another reason to learn diagnostic radiology coding is because it is a good account for new coders to get their feet wet. Why do they start with the radiology accounts? Because it is easier than starting with other types of coding, say brain surgeries, transplants etc. While it’s true that it is easier than some types of coding, it has it’s own set of rules, and is a specialty in and of itself. If you are a diagnostic radiology coder, not only will you become proficient in aspects of CPT coding, you will become familiar with all sections of the ICD-10-CM book. You use a full range of codes which is a very valuable skill set. Even if you decide not to stay in diagnostic radiology coding–these skills transfer over to other coding specialties.

So, to make a long story short, there are many different coding specialties, and unfortunately some coding does end up going offshore, in ALL specialties. But you would be doing yourself a disservice if you decide not to learn diagnostic radiology coding based on that alone. There are thousands of radiologists in this country and many of them see the benefits of having the coding of their practice stay in the US. Not only that, radiology coding lends itself to learning so many different aspects of CPT and ICD-10-CM coding and these skills are valuable for any coder to have.
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What Is Diagnostic Radiology Coding?

If you’ve ever been to the ER for an injury or sickness, you’ve most likely had an x-ray done. A radiologist had to interpret and read that x-ray, and then dictate a report. Once the report is finalized it has to be coded and then billed.

A diagnostic radiology coder is a someone who is trained and specializes in coding different types of radiology procedures, including: x-rays, ct scans, mri’s, ultrasounds, duplex scans, dexa scans, mammograms just to name a few. It is a small compartment of the medical coding world, but it is also very interesting from a coding point of view. You code many different procedures with different diagnoses, so it is not boring at all!

To see a quick overview of how to look up radiology codes in the cpt book, click here.

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Welcome

Welcome

 

Midnight Medical Coding is owned and managed by Lindsay Della Vella BS, COC. Our mission is to provide high quality, affordable educational materials related to diagnostic radiology coding. We supply free youtube tutorials, blog posts, discussions on social media, and practice radiology coding exercises. Our main products are online courses geared towards new radiology coders or coders in other specialties looking to learn more about diagnostic radiology coding.

 

To have a bright future in the medical coding world, you have to be educated. But not only that, you have to know what you’re doing right from the beginning. It can be very intimidating your first day on diagnostic radiology coding job. This website was created with the hope that a new coder could find everything they need in one place. Need a list of common diagnostic radiology codes? Got it! Want to watch a webinar and learn something new? Got it! What about a practice coding test? Got it! Here you will find all that and more.

Once you spend some time browsing here, you will no doubt be a better diagnostic radiology coder!
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